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2315 Dougherty Ferry Rd Saint Louis MO 63122-3383 | |
| (314) 977-6828 | |
| (314) 977-5268 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2315 Dougherty Ferry Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Alyce Lanxon (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3149776828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3545 Lindell Blvd Fl 3 Saint Louis MO 63103-1020 Ph: (314) 977-6828 | 2315 Dougherty Ferry Rd Saint Louis MO 63122-3383 Ph: (314) 977-6828 |
| NPI Number | 1487627717 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 09/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487627717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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